Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

New Triterpenoids from Peucedanum ruthenicum: Triterpenoids from Peucedanum ruthenicum

From hexanic extract of aerial parts of Peucedanum ruthenicumM. Bieb (Apiaceae) collected from Mazandaran province of Iran, four triterpenoids namely taraxasterol, y-taraxasterol, poriferasterol and b-sitosterol have been isolated by column chromatography, thin layer chromatography, and crystallization. Their structures were elucidated by spectroscopic methods (UV, IR, MS, 1Hand13C-NMR)

Chemical Constituents and Antibacterial Activity of Essential Oil of Peucedanum ruthenicum M. Bieb. Fruits: Peucedanum ruthenicum essential oils

The essential oil of Peucedanum ruthenicum fruits, obtained by hydrodistillation, was analyzed by gas chromatography and gas chromatography-mass spectrometry. Among the 31 identified constituents accounting for 83.9% of the total oil, the major components were 1,8-cineole (11.15%), camphor (5.86%), Z-carveol (6.88%), lcarvone (5.61%), 8,9-dehydroisolongifolene (11.35%), caryophyllene oxide (13.65%),and caryophylla-4(12),8(13)-dien-5-β-ol (5.19%). Antimicrobial activity of the essential oil was investigated against various gram-positive and gram-negative bacteria. The essential oil of P. ruthenicum showed activity against gram-positive bacteria but had no effect on the tested gram negative bacteria

Flavonoid Glycosides from Tribulus terrestrisL.orientalis: Flavonoids from Tribulus terrestrisL

Tribulus terrestrisL. var. orientalis(Kerner) G. Beck is widely used in the traditional medicine of many countries. Several flavonoides are identified from the plant material. Aerial parts which collected from northeast of Iran are used in this study. Three flavonoid glycosides were isolated and characterized. The flovonoids were found to be based on quercetin and kaempferol. Flavonoid glycosides whichs eparated were consisted of quercetin 3-O-glycoside, quercetin 3-O-rutinoside and kaempferol 3-O-glycoside. The latest one was a new for the plant

Chemical Constituents and Antibacterial Activity of Essential Oil of Prangos ferulacea (L.) Lindl. Fruits: Essential oil of Prangos ferulacea

The essential oil of Prangos ferulacea (Apiaceae) fruits was obtained by hydrodistillation and analyzed by gas chromatography (GC) and GC-mass spectrometery (MS). Among the 39 identified constituents accounting for 99.99% of the total oil, the major components were chrysanthenyl acetate (26.53%), limonene (19.59%), alpha pinene (19.50%), delta-3-carene (6.56%), mesitaldehyde (6.09), and germacrene-B (3.55%). Antimicrobial activity of the essential oil was investigated against some gram positive and gram negative bacteria. The essential oil of P. ferulacea showed activity against Staphylococus aureus, S. epidermis, Eschrechia coli and Pseudomonas aeroginosa

Analyzing the Educated Dimensions of Malik Ashtar’s Personality in Nahj al-Balagha as a Model Governor and Ruler

Malik Ashtar is a personage educated based on the educational doctrines of Islam in Nahj al-Balagha. The way he was educated led to his selection as one of the governors and rulers during the Imamate (leadership) of Imam Ali (A.S.). Accordingly, this study aimed at identifying the componenets of his educated personality in various dimensions (physical, religious, moral, political, economic, social, intellectual, and emotional). To this end, we used content analysis and semantic network. According to this method, the propositions and themes related to Malik Ashtar’s personality dimensions in Nahj al-Balagha and related historical books were first identified and coded and then analyzed. The research results indicated that Malik Ashtar was educated in various educational dimensions including enjoying physical strength and health, having spiritual beliefs, commitment to righteous deeds and moral virtues, struggling with oppression, doing justice, and making effort to have unity and strength of government, paying attention to people’s material welfare, cooperation and assistance, intellectualism, recognition and insight, affection and loving, and moderation. This can be an inspiration for educating competent rulers and governors in the Islamic society of Iran

Chemical Composition of the Essential Oils of Peucedanum ruthenicum (M. Bieb.) Rochel Leaves and Flowers from Kalardasht: Essential oil of Peucedanum ruthenicum

The essential oils of leaves and flowers of Peucedanum ruthenicum (M. Bieb.) Rochel (Umbelliferae) were prepared by hydrodistillation separately and analyzed by GC and GC-MS, and the composition of both essential oils were compared together. Sixteen and eleven compounds were identified in leaves and flowers essential oils representing 100% and 96.4% of total oils, respectively. The major components were thymol (57.79%), b-bisabulene (6.10%) for the leaves oil, germacrene-D (45%) and germacrene-B (18.5%) for the flowers oil. The amounts of monoterpenes and sesquiterpenes were not found nearly to be equal in oils of the two parts of the plant

Antibacterial Activity of Peucedanum ruthenicum, Johreniopsisseseloidesand Cervaria cervariifoliaExtracts: Antibacterial activity of plant extracts

Antimicrobial activity of the polar and nonpolar extracts of the roots and aerial parts of Peucedanum ruthenicumM. Bieb., Johreniopsis seseloides (C. A. Mey.)Pimenov and Cervaria cervariifolia(C. A. Mey.) Pimenov were examined against gram-positive and gram-negative bacteria. The polar extracts of the roots and aerial parts displayed no activity against bacteria, while the nonoplar extracts of the roots which contains coumarins, presented activity againstStaphylococcus aureus, S.epidermidis, Pseudomonas aeruginosaand Escherichia coli